Endoscopic and surgical management of early esophageal cancer: Current evidence and evolving oncologic strategies

Table 3 Comparison of treatment strategies for early esophageal cancer

Treatment strategy	Advantages	Limitations
Esophagectomy	Complete tumor and lymph node removal; established oncologic standard for invasive disease	Highly invasive; significant perioperative morbidity and mortality; long recovery; loss of gastroesophageal junction; impaired quality of life
Endoscopic mucosal resection	Minimally invasive; low procedure-related mortality; effective for small, superficial mucosal lesions; short recovery time	Limited to small lesions; often requires piecemeal resection; reduced accuracy of pathological margin assessment; higher local recurrence for large lesions
Endoscopic submucosal dissection	En bloc resection regardless of lesion size; precise pathological evaluation; lower recurrence rates; organ preservation	Technically demanding; longer procedure time; higher risk of perforation and stricture; limited availability in some regions